Don`t let Israel legalize force feeding of hunger strikers

On February 16th 2014, PHR Israel sent a letter to the Ministry of Health (MOH) protesting its support of the Proposed Amendment to the Prisons Act

A similar letter was sent by PHR Israel and Adalah calling on Attorney-General Yehuda Weinstein, to withdraw his support to the Proposed Amendment to the Prisons Act [New Form] (Preventing the Damages of Hunger Strikes), 5773-2013

The organizations object the proposed amendment as:

It incorporates significant violations of human rights and medical ethics;
It provides a legislative foundation for torture by permitting and providing for the enforced feeding and treatment of the hunger strikers;
It makes ill use of medicine and of physicians in order to achieve a political-security and enhance Israel’s public image;
It is in direct violation of the Patient’s Rights Act and of international declarations and treaties.
For the letters see: https://www.phr.org.il/default.asp?PageID=116&ItemID=1885

The Motivation for the Proposed Amendment Is Political Oppression:
Although the language of the amendment seems to emphasize the sanctity of life of the hunger striker, various authorities behind this proposed amendment have publically indicated that its aims are political: preventing political gains from Palestinian hunger strikes. For example, the legal advisor to the Ministry of Public Security (MOPS), Att. Yoel Adar, interview on Channel 10 (March 3rd 2014):

Why was the law needed? The aim is indeed to defend the public, Israel’s citizens. This is our job. We need to defend them from events that may harm them.”
When asked how hunger strikes can harm the public he explained:
“if he [the hunger striker] dies in prison, it causes riots, in prison, in Judea and Samaria, in Palestinian territories. This has definite implication on Israel.”
When confronted with the Israeli Medical Association (IMA) and PHR-Israel’s objection to forced feeding as a breach of medical ethics, and possibly of the convention against torture, Att. Adar said:
“You should remember that with all due respect, doctors receive their license from the Ministry of Health, not from the IMA,…A doctor will be found that will think through the Zionist lenses, from the point of view where public interests are not less important than any other interest, and he will take care so he [the hunger striker] shall be fed.”

A decision concerning medical intervention in a hunger strike will be made by a district court.
The court will weigh: the prisoner’s health, his/her prognosis, his/her position, the Israeli Prison Service’s duty of preserving his/her life, prison order, and state security.

The Amendment is both Unnecessary and Unwise:
The State and relevant authorities have other options available to prevent a situation where Palestinian prisoners feel forced to choose the last-resort action of a hunger strike. Authorities can and should examine their policy of detention and imprisonment of Palestinians and conditions under which they are interrogated, tried and held.

Past experience proves that in most cases following professional and ethical guidelines allows a doctor to establish good communication with hunger strikers in a way that leads to a life-saving resolution. When allowed, external physicians became intermediaries between the hunger strikers and the prison authorities, and prevented the deterioration in the condition of the hunger strikers.

The amendment is in complete violation of international treaties and declarations including the World Medical Association’s (WMA) 1975 Declaration of Tokyo This prohibits the participation of physicians in torture and clearly states that hunger-striking prisoners will not be fed, nourished, or treated by force (the declaration was adopted by the IMA); the 2006 WMA Declaration of Malta on hunger strikers that explicitly prohibits force-feeding; the Istanbul Protocol and The United Nations Convention Against Torture (UNCAT).

Many hunger strikers who were treated and force-fed have described the experience as being one of serious physical and emotional suffering, as degrading and cruel and equivalent to rape and torture. We see the force-feeding and forced treatment of people whose liberty has been denied and who are at the mercy and under the complete control of the state authorities as an action which amounts to torture, cruel, degrading, and inhumane treatment. The language of the proposed amendment prepares the ground for the participation of physicians in this conduct.

The amendment is in contravention and circumvention of existing legislation mainly of the Patient’s Rights Act, that anchor the duty to provide medical care in informed consent, even in the case of medical emergency. The Law also considers cases in which the patient objects to the treatment, and permits forced treatment under strict conditions, which respect the patient’s wishes or the assumptions about such wishes, allowing it if – among other conditions “there are reasonable grounds to suppose that, after receiving treatment, the patient will give his retroactive consent”

Context:
The amendment to the Prison Act is part of increased legislative efforts aimed at subordinating codes of different professional communities to the “greater good”.

It is true that the proposed amendment does not force a doctor to fulfil a possible judicial decision of forced feeding. But, as with torture, a public atmosphere and political pressure to subdue professional ethics and conduct to the “greater good” prepares the ground and encourages doctors to participate in what is clearly a violation of the professional code of ethics.

To conclude, we call on you to denounce this proposed amendment, which violates a long tradition of principles of medical ethics, local law and international treaties. We view this proposed amendment as a significant element of a policy that is designed to establish security (narrowly and manipulatively defined) as the greater good that demands all other codes of ethics or professional conduct to bow down before it.

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